Monocytosis is an adverse prognostic factor for survival in younger patients with primary myelofibrosis

✍ Scribed by M.A. Elliott; S. Verstovsek; D. Dingli; S.M. Schwager; R.A. Mesa; C.Y. Li; A. Tefferi

• Publisher: Elsevier Science
• Year: 2007
• Tongue: English
• Weight: 297 KB
• Volume: 31
• Category: Article
• ISSN: 0145-2126
• DOI: 10.1016/j.leukres.2006.12.025

✦ Synopsis

We recently developed a modified Dupriez prognostic scoring system (PSS) that effectively discriminated between high-, intermediate-, and low-risk young patients (age < or =60 years) with primary myelofibrosis (PMF) based on the respective presence of none, one, or two or more of the following parameters: hemoglobin <10 g/dL, leukocyte count <4 or >30 x 10(9)L(-1), and platelet count <100 x 10(9)L(-1). The current study (n=129; median age, 52 years; 69 males) reveals, on multivariable analysis, that an absolute monocyte count of > or =1 x 10(9)L(-1) carries an independent predictive value (p=0.02), for an inferior survival, in addition to that provided by hemoglobin level (p=0.002), platelet count (0.02), and leukocyte count (p=0.16). The inclusion of the monocyte count as a fourth risk factor enabled the construction of a new and improved Mayo PSS; median survival was 173, 61, and 26 months in the absence of all four (low-risk), three (intermediate-risk), or two or less (high-risk) adverse features, respectively (p<0.0001). The independent prognostic value of monocytosis was validated in a separate database of 97 patients with PMF from another institution.